| NPI | 1760804546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024171909) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NJ 26NJ00439500) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2022-08-24 |